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Long-term Service and Support

ARChoices in HomecareARChoices is a Medicaid program that includes home and community-based services for adults ages 21 through 64 with a physical disability and seniors age 65 or older. Services include:

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Attendant Care

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Home-Delivered Meals

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Personal Emergency Response System (PERS)

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Adult Day Services

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Adult Day Health Services

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Facility-Based Respite Care

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In-Home Respite Care

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Environmental Modifications

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Adult Family Home

Eligibility requirements

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Age 21 or older

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If under age 65, have a physical disability

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Determined to be at a nursing home intermediate level of care

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Financially eligible

Money Follows the PersonThe Arkansas Money Follows the Person application has transitioned 477 individuals who have resided in institutions 90 consecutive days and one day on Medicaid into qualified home and community-based programs. The following populations residing in nursing homes and and (Intermediate Care Facility for the Intellectually Disabled) ICF/IDs will be served: Individuals with developmental or intellectual disabilities, individuals 19 to 64 with physical disabilities; and individuals age 65+.Minimum Eligibility prior to transition:

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A period of 90 days that includes hospitalization and current recipient of Medicaid benefits for in-patient services for at least 1 day.

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Populations targeted for transition:

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Elderly; adults (18 and over) with physical disabilities, individuals with developmental or intellectual disabilities; and individuals with mental illness.

Qualified Facilities

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Licensed nursing homes, the Arkansas Health Center under the administration of the Division of Behavioral Health and ICFs.

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Qualified Residence in Community:

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A home leased or owned by the individual or the individual's family member; and apartment with an individual lease; or a residence, in a community-based residential setting in which no more than 4 unrelated individuals reside.

IndependentChoicesIndependentChoices provides assistance with activities of daily living such as bathing, dressing, walking, or toileting and allows you or your representative the opportunity to hire the person who will provide the needed services. Medicaid provides the funding, but you are responsible to ensure the needed services are provided.You Choose:

If you do not receive ARChoices waiver services, call Palco, a DHS contractor, 1-866-710-0456 to start a referral. Palco is responsible for ensuring you understand employer responsibilities.

Living Choices (Assisted Living)Living Choices Assisted Living is a home and community-based services waiver that is administered jointly by the Division of Aging and Adult Services (DAAS) and the Division of Medical Services (DMS).The assisted living environment encourages and protects individuality, privacy, dignity and independence. Each Living Choices participant receives personal, health and social services in accordance with an individualized plan of care developed and maintained in cooperation with DAAS-employed registered nurse. Aparticipant's individualized plan of care is designed to promote and nurture his or her optimal health and well-being.Living Choices providers furnish 'bundled services' in the amount, frequency and duration required by the Living Choices plans of care. They facilitate participants' access to medically necessary services that are not components of Living Choices bundled services, but which are ordered by participants' plans of care. Living Choices providers receive per diem Medicaid reimbursement for each day a participant is in residence and receives services. The per idem amount is based on a participant's 'tier of need,' which DAAS-employed RNs determine and periodically re-determine by means of comprehensive assessments performed in accordance with established medical criteria. There are four tiers of need.Living Choices participants are eligible to receive up to nine Medicaid-covered prescriptions per month.Eligibility requirements:

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Medicaid-eligible persons

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Aged 21 and older

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Has been determined by Medicaid to be eligible for an intermediate level of care in a nursing facility.

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The individual must be a person with a physical disability, blind or elderly.

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Participants in Living Choices must reside in Level II assisted living facilities (ALFs), in apartment-style living units.

Program of All-Inclusive Care for the Elderly (PACE)PACE serves individuals who are age 55 or older, certified by their state to need nursing home care, able to live safely in the community at the time of enrollment and live in a PACE service area. While all PACE participants must be certified to need nursing home care to enroll in PACE, only about 7 percent of PACE participants nationally reside in a nursing home. If a PACE enrollee needs nursing home care, the PACE program pays for it and continues to coordinate the enrollee's care.Services include the following:Delivering all needed medical and supportive services, a PACE program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their home for as long as possible.

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Adult day care that offers nursing; physical, occupational and recreational therapies; meals; nutritional counseling, social work and personal care;

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Medical care provided by a PACE physician familiar with the history, needs and preferences of each participant;

Alternative Community Service WaiverThe Developmental Disability Services Alternative Community Services (DDS ACS) waiver program is for persons who, without Home and Community-Based Services (HCBS), would require services in an institution. Participants must not be residents of a hospital, nursing facility or an Intermediate Care Facility for Individuals with Intellectual Disabilities. DDS ACS eligibility requires a determination of categorical eligibility, a determination of level of care, and the development of a service plan. The DDS ACS program offers choice of home and community based services or institutional services.Services supplied through this program are:

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Supportive living

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Respite care

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Supplemental support services

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Supported employment services

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Environmental modifications

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Adaptive equipment

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Specialized medical supplies

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Case management services

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Transitional case management services

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Community transition services

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Consultation services

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Crisis intervention services

Eligibility requirements:

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Developmental Disability Diagnosis (onset before the age of 22)

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Substantial functional limitations in 3 of 6 major life activities (self-care, language, learning, mobility, self-direction or independent living) AND

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Medicaid income eligibility requirements

Developmental Day Treatment Clinic Services (DDTCS)Developmental Day Treatment Services (DDTCS) is a program for adults age 21 (age 18 to 21 if the person has a diploma /certificate of completion). Services are provided in a clinic setting on an out-patient basis. Services include evaluation, instruction in areas of self-help, socialization and communication to help the person to develop and retain skills related to their ability to live in the community. Options for speck, physical and occupational therapy are available.Eligibility requirements:

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Developmental Disability Diagnosis (onset before the age of 22)

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Substantial functional limitations in 3 of 6 major life activities (self-care, language, learning, mobility, self-direction or independent living) AND

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Medicaid income eligibility requirements

Rehabilitative Services for Persons with Mental Illness (RSPMI)RSPMI is rehab for people with mental illnesses in some cases, to help them fit in or just to help them feel better. The care must be provided by a certified RSPMI provider. Medicaid must approve these services before they are provided, or Medicaid will not pay. The RSPMI provider should handle getting Medicaid’s approval. A referral from a primary care provider (PCP) may be required for children under age 21. If the person needs more than eight hours of care within a 24-hour period, the doctor or other provider will need to apply for an “extension of benefits” for the patient.Eligibility requirements:

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Mental illness or behavioral health need

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Prior authorization from Medicaid

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If Under the age of 21, physician referral

Licensed Mental Health PractitionersThese are visits with a mental health worker who is licensed to provide certain types of care. Medicaid will pay with a referral from a doctor. In some cases, Medicaid will need to approve the services in advance. The doctor or mental health worker should handle getting the services approved.Eligibility requirements:

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Mental illness or behavioral health need

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Physician referral

Inpatient Psych services for under age 21Sometimes people with mental illnesses need to stay at a hospital or mental health center. Medicaid will pay for this only for children under age 21, and only with a doctor’s referral. Medicaid must approve these services in advance, except in an emergency. The patient will also need a “certificate of need” in order for Medicaid to pay. The doctor who refers the patient should provide this.Eligibility requirements:

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Under the age of 21

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Physician referral

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Medicaid recipient or Medicaid eligible

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Certificate of need from the referring physician

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Mental illness or behavioral health need

Substance abuse treatment services (SATS)The SATS program will cover the following services:

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Addiction Assessment

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Treatment Planning

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Care Coordination

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Multi-person (family) Group Counseling

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Individual Counseling

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Group Counseling

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Marital/Family Counseling

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Medication Management

Eligibility requirements:

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Children and adolescents aged 9 and up to 21 years old.

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Pregnant women through the last day of the month in which the 60th post-partum day falls.

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Experience with substance abuse

School based mental healthThe School-Based Mental Health Services Program provides mental health services to children under age 21 who are in school and who have a mental health problem. Medicaid will pay for these services if:

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The child has a referral from a doctor. The referral must be renewed every six months.

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Care is provided by a mental health worker who works for the school or under a contract with the school

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A mental health exam shows the child needs these services

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The services are part of a treatment plan

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The services are provided at a public school or at the child's home if the child is enrolled in the public school system but attends school at home.

Eligibility requirements:

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Under the age of 21

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Enrolled in school

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Mental illness or behavioral health need

First Connections Early Intervention ProgramDDS First Connections Program provides and oversees early intervention for infants and toddlers birth to three years old with developmental delay or disability. Infants or toddlers under the age of three who are experiencing a significant delay in one or more area of development (physical, cognitive, communication, adaptive, social emotional) or who have a medical diagnosis likely to result in developmental delay are eligible for First Connections. Early intervention is designed to assist the child’s caregivers in promoting the infant’s/toddler’s active participation in typical child and family activities. Supports and services are provided in the child’s natural environment (home and community locations where all children live, learn, and play). Families of toddlers who still need developmental support are assisted in creating a transition plan prior to the child’s third birthday to ensure a smooth transition to preschool services at three. DDS works with local community providers to ensure that intervention complies with Part C of the Individuals with Disabilities Education Act (IDEA).Eligibility requirements:

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Infants or toddlers under the age of three AND

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Experiencing a significant delay in one or more area of development (physical, cognitive, communication, adaptive, social emotional) or who have a medical diagnosis likely to result in developmental delay are eligible for First Connections.

Title V Children with Special Health Care NeedsThe Title V Children with Special Health Care Needs program is located in the Division of Developmental Disabilities Services (DDS) Children’s Services unit. This is a federal program that, in Arkansas, serves children and youth with chronic medical conditions. To qualify, the child must be determined medically eligible and the family must be determined financially eligible. Financial eligibility is based on a sliding scale based on verified gross monthly income and the size of the family. Income up to 185% of the Federal Poverty Level is considered eligible for full coverage for eligible conditions and limited eligibility is possible for families with verified income from 185 to 250% of the Federal Poverty Level. Families are referred for Medicaid applications if it appears they or the child would be eligible. If there is no Medicaid coverage, the Title V program can assist with payment for medical care as funding is available for the eligible condition only. Private insurance (when covering the child) must be billed for the medical care before payment is made by Title V. Providers must be willing to accept Title V payment.Eligibility requirements: